When we perform breast augmentation and when breast augmentation with breast uplift?

In plastic surgery there are some cases were they are borderline concerning their indications. When we say indication we mean “which is the appropriate surgery for each occasion”. As far as breast concerns, for example, we know that when the case concerns a woman with small breasts and not special skin laxity then the appropriate procedure for her is breast augmentation. We know that the appropriate surgery for a woman with small breast and skin laxity is breast augmentation in combination with breast lift.

There are also cases with small degree of skin laxity that makes it hard to decide if breast augmentation is enough or is needed breast augmentation in combination with breast lift. The most preferred choice is to solve the problem only with breast augmentation because the last one has the disadvantage of the sections. The reason is that some of these sections end up in scars which remain.

In which cases is recommended only breast surgery as far as there is only a small degree of skin laxity?

Breast augmentation is highly recommended to small sized breasts that we want to enlarge but at the same time a breast where its nipple is placed only a few centimeters over the inframammary fold. We want to remind that inframammary fold is the point underneath where the breast folds. Of great importance, in order to decide which surgery is suitable, is the height of the nipple and the inframammary fold. As we have already mentioned, if the height of the nipple is some centimeters over the inframmary fold then we can easily decide to perform only breast augmentation. In these cases the breast lift will happen automatically due to the volume that the breast will gain which will give the desired shape and the breast will be lifted. If the height of the nipple is lower than the inframammary fold level then we are led to breast lift in combination with breast augmentation if of course breast augmentation is needed.

But what happens with the mid-cases?

Mid-cases are those where the nipple is at the same level with the inframammary fold or a bit over it. In these cases plastic surgeon’s experience is what matters the most. He will have to be connoisseur of all possible techniques of breast augmentation so that he won’t have limited options. For these border line cases there is a number of specific techniques that can be of great help.

  1. Dual plan technique. This technique is invented in order to help cases of breasts with a small grade of laxity and can lift a bit the nipple. It’s a technique that demands the abruption of tissues in two levels, mainly under pectoralis major muscle but also partly over it.
  2. Shift of inframammary. With specific techniques inframammary fold can be shifted a lit bit lower in order to fix the height difference between inframammary and nipple. This is a technique that should be performed with great attention, in certain occasions that only an experienced plastic surgeon is aware and in limited extension.
  3. The choice of the proper implant. Some implants, cause of their shape, can be more helpful in this border line cases. The plastic surgeon must have the experience to choose the appropriate implant for the right case, something that is not very easy in such cases.


As we can see, there are special techniques for these border line cases concerning breast augmentation. And by saying border line cases we mean the cases where is not obvious which technique should be chosen between breast augmentation and breast augmentation+breast lift combination.

Because there is no specific line on when we choose the first or the second method, plastic surgeon’s experience will be critical in order to propose and implement the correct method. Plastic surgeon would have to make a proper evaluation, describe the situation and propose the indicated solutions and after that the person interested in that with maturity should choose the solution that will give her the best results.


The whole effort is to face each case only with breast augmentation with no need of combining breast lift which has the disadvantages of the incisions and therefore the scars.


Athanasios Christopoulos

Plastic Surgeon